Clinical, Epidemiological, Laboratory and Therapeutic InvestigationAbstract: BACKGROUND -Several dermatologic findings have been associated with coronary artery disease and represent easily visualized signs that may contribute to classify cardiac risk by a non-invasive technique. OBJECTIVES -To evaluate the prevalence of some dermatologic findings in patients with or without coronary artery disease. METHODS -A case-control study involving male patients submitted to coronary angiography was performed. We included patients with greater than 50% obstruction of at least one coronary artery. Both groups were assessed as to presence of diagonal earlobe crease and preauricular crease, alopecia and thoracic hairiness. The results were adjusted for known cardiac risk factors: age, body mass index, diabetes, hypertension, dyslipidemia and smoking. RESULTS -One hundred and ten individuals were evaluated (80 patients, 30 controls). The prevalence of diagonal earlobe crease in patients (60%) was greater than controls (30%) (p<0.05). Androgenetic alopecia and thoracic hairiness were not associated to coronary artery disease. The odds ratio for diagonal earlobe crease was 3.1 (1.2-8.3) and for preauricular crease was 5.5 (1.9-16.3). The simultaneous finding of diagonal earlobe crease and preauricular crease resulted in a positive predictive value of 90.0%. CONCLUSIONS -The study detected a positive association between bilateral diagonal earlobe crease and bilateral preauricular crease with coronary artery disease. The simultaneous finding of both folds had high predictivity for coronary artery disease. Keywords: Coronary arteriosclerosis; Ear, external; Male; Risk factors de 3,1 (1,2-8,3) e para prega anterotragal foi de 5,5 (1,9-16,3 Resumo: FUNDAMENTOS -Diversas alterações dermatológicas foram associadas à doença arterial coronariana
Resumo:São diversos e comuns os efeitos mucocutâneos dos quimioterápicos, alguns por ação citotó-xica, outros por hipersensibilidade ao fármaco. Os autores relatam a ocorrência de inflamação em múl-tiplas queratoses seborreicas pré-existentes, após terapia citorredutora com gencitabina, em paciente sob tratamento para neoplasia de pâncreas. Discutem, ainda, a benignidade do evento e alertam para a necessidade de adequada identificação dos efeitos cutâneos decorrentes da quimioterapia sistêmica. Palavras-chave: Antineoplásicos; Antineoplásicos/efeitos adversos; Ceratose seborreica; Inibidores da síntese de ácido nucleico Abstract: There are several common mucocutaneous adverse effects related to chemotherapy, either by direct cytotoxic action or by hypersensitivity to the drugs. The authors report inflammation in multiple seborrheic keratoses after chemotherapy with gemcitabine in a patient under treatment for pancreatic cancer. Moreover, they discuss the relative benignity of this event and warn about the need to correctly identify systemic chemotherapy-induced skin adverse effects. Keywords: Antineoplastic agents; Antineoplastic agents/adverse effects; Keratosis, seborrheic; Nucleic acid synthesis inhibitors Recebido em 14.11.2008 INTRODUÇÃOQueratoses seborreicas, ceratoses seborreicas ou verrugas seborreicas são lesões cutâneas benignas comuns na idade adulta, originadas da epiderme, usualmente acastanhadas, tendo como principal característica a proeminência folicular, com formação de pseudocistos e pseudoaberturas foliculares. O tórax é o local mais acometido, mas as lesões podem ocorrer em qualquer área do tegumento. 1 Sua etiologia é desconhecida, com forte associação familiar, sendo mais comuns entre caucasianos. Recentemente, tem-se postulado que fatores de crescimento epidérmicos participam da sua gênese.Eventos inflamatórios -como eczemas -, quimioterapia e neoplasias internas podem tanto levar ao surgimento de queratoses seborreicas como promover sua inflamação.2 O crescente uso de novas drogas quimioterápi-cas tem como consequência a ocorrência de novos efeitos adversos, cutâneos e não cutâneos. Os análo-gos de nucleosídeos (AN), dentre eles a gencitabina, são conhecidos pela possibilidade de causar inflamação súbita de queratoses seborreicas. 3,4,5,6 Inflamação de queratoses actínicas e carcinomas espinocelulares também é relatada com outros quimioterápicos. 7Os autores apresentam caso de inflamação de queratoses seborreicas após uso de gencitabina em paciente sob tratamento de neoplasia de pâncreas. RELATO DO CASOMulher, branca, de 58 anos, apresentou quadro de icterícia súbita, sendo submetida a ultrassonografia de abdome, em que foi demonstrada dilatação do
Intense pulsed light (IPL) is a non-laser, versatile light technology that is a key tool in dermatology. It is widely used for the treatment of photoaged skin. Also, it is used for hair removal, acne treatment, and treatment of vascular lesions. IPL works through selective photothermolysis to reduce dark spots, telangiectasia, wrinkles, and skin laxity (photorejuvenation) caused by chronic sun exposure. This chapter will discuss all the aspects about the physics behind the IPL technology, clinical indications, treatment, and possible complications.
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